Modern view on therapeutic strategies for advanced lung cancer with a BRAF mutation. A review
TL;DR
The implementation of molecular genetic testing to identify driver mutations prior to initiating treatment, alongside first-line targeted therapy, is a critical factor in improving survival rates for patients with advanced NSCLC and the BRAF V600E mutation.
Abstract
This article examines contemporary treatment strategies for advanced non-small cell lung cancer (NSCLC) with a BRAF gene mutation, which is observed in approximately 5% of NSCLC patients. The significance of molecular genetic testing to detect the BRAF V600E mutation in all patients diagnosed with advanced NSCLC is underscored. The article describes the principles guiding the selection of treatment regimens for NSCLC with BRAF V600E mutation, highlighting the need to use targeted therapies in the first line due to their association with the highest objective response rates and survival outcomes. Various factors should be considered when selecting the first-line regimen, including the Eastern Cooperative Oncology Group (ECOG) performance status, the presence of intracranial metastases, concurrent medical conditions, and the patient’s tolerance to antitumor therapy. Detailed results from a phase II PHAROS clinical study evaluating the efficacy and safety of encorafenib in combination with binimetinib in patients with metastatic NSCLC exhibiting the BRAF V600E mutation are presented. This study reported the most favorable overall survival to date in treatment-naive patients with BRAF V600E-mutated metastatic NSCLC, with an overall survival of 47.6 months, surpassing that achieved with other systemic therapies. Hence, the implementation of molecular genetic testing to identify driver mutations prior to initiating treatment, alongside first-line targeted therapy, is a critical factor in improving survival rates for patients with advanced NSCLC and the BRAF V600E mutation.